4GC-14136-09645

3 vaccinations 11 coded responses 32 check-ins 11 free-text entries 4 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 186 / PA
Registered: 2021-02-09

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-29
Dose 1 — Moderna
2021-02-09
Registered in v-safe
2021-02-09
Survey response — day 7, dose 1
MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain · Headache

Free text: Swollen gland under armpit of arm that received 1st dose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — day 14, dose 1
MedDRA: Abdominal pain — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Severe Left lower quadrant pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-19
Survey response — day 21, dose 1
MedDRA: Headache — Feeling: Fair

Free text: Headaches every day or every other day since receiving first vaccination

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Dose 2 — Moderna
2021-02-26
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Lymph node pain — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Swollen gland painful in armpit on side where I received the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · Headache

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-05
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-14
Health check-in — day 14, dose 2
Feeling: Poor

Adult check-in
2021-03-21
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-27
Survey response — day 28, dose 2
MedDRA: Oedema peripheral — Feeling: Fair

Free text: Swollen lymph node under arm, vaccination side

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-28
Call 1 — Left Voicemail
2021-08-29
Survey response — 6 months, dose 2
MedDRA: Ear discomfort, Eustachian tube dysfunction, Headache, Ovarian cyst — Feeling: Good · Be unable to work or attend school

Free text: Ovarian cyst, headaches, blocked ears, eustation tube dysfunction

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-29
Dose 3 — Moderna
2021-11-30
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-01
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-12-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness · Fatigue or tiredness

Adult check-in
2021-12-06
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-15
Survey response — day 14, dose 3
MedDRA: Ear pain, Headache, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Headaches and i ner ear pain... similar to that of 2nd dose · Healthcare visit (other): Scheduled ent condult in February

MedDRA releases: 2024-11 · check-in free text available
2021-12-15
Report sent to call center — day 14, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-16
Call successful
Participant prefers to complete VAERS report online
2021-12-20
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-27
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-03
Survey response — day 35, dose 3
MedDRA: Pregnancy, Premature ovulation — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Rec'd booster, ovulated 1 week early, positive pregnancy test, awaiting viability of pregnancy

MedDRA releases: 2024-11 · check-in free text available
2022-01-03
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-28
Survey response — 3 months, dose 3
MedDRA: Abortion spontaneous, Surgery — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Had miscarriage. Received vaccine during ovulation · Healthcare visit (other): Required surgery 2x

MedDRA releases: 2024-11 · check-in free text available
2022-02-28
Report sent to call center — 3 months, dose 3
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-03-04
Call 1 — Left Voicemail
2022-06-01
Survey response — 6 months, dose 3
MedDRA: Abortion spontaneous — Feeling: Good · Be unable to work or attend school

Free text: Had miscarriage after getting covid 19 vaccine

MedDRA releases: 2024-11 · check-in free text available
2022-11-29
Survey response — 12 months, dose 3
MedDRA: Pregnancy — Feeling: Good

Free text: Pregnancy

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-29	Moderna
2	2021-02-26	Moderna
3	2021-11-29	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-12	Successful	Participant prefers to complete VAERS report online
2021-12-15	Successful 2021-12-16	Participant prefers to complete VAERS report online
2022-01-03	Unsuccessful
2022-02-28	Unsuccessful

Free text

Release 3 — day 7, dose 1

2021-02-09

Systemic reaction (other): Swollen gland under armpit of arm that received 1st dose

Release 4 — day 14, dose 1

2021-02-12

Symptoms: Severe Left lower quadrant pain

Release 4 — day 21, dose 1

2021-02-19

Symptoms: Headaches every day or every other day since receiving first vaccination

Release 4 — days 1–6 daily, dose 2

2021-03-01

Systemic reaction (other): Swollen gland painful in armpit on side where I received the vaccine

Release 6 — day 28, dose 2

2021-03-27

Symptoms: Swollen lymph node under arm, vaccination side

Release 9 — 6 months, dose 2

2021-08-29

Symptoms: Ovarian cyst, headaches, blocked ears, eustation tube dysfunction

Release 10 — day 14, dose 3

2021-12-15

Symptoms: Headaches and i ner ear pain... similar to that of 2nd dose

Healthcare visit (other): Scheduled ent condult in February

Release 10 — day 35, dose 3

2022-01-03

Symptoms: Rec'd booster, ovulated 1 week early, positive pregnancy test, awaiting viability of pregnancy

Release 11 — 3 months, dose 3

2022-02-28

Symptoms: Had miscarriage. Received vaccine during ovulation

Healthcare visit (other): Required surgery 2x

Release 11 — 6 months, dose 3

2022-06-01

Symptoms: Had miscarriage after getting covid 19 vaccine

Release 12 — 12 months, dose 3

2022-11-29

Symptoms: Pregnancy

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".

MedDRA terms by release

Field	Preferred term	2021-09	2023-04	2024-11
HCVO	Surgery	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Abdominal pain	✓	✓	✓
SD	Abortion spontaneous	·	·	✓
SD	Ear discomfort	✓	·	✓
SD	Ear pain	·	·	✓
SD	Eustachian tube dysfunction	✓	·	✓
SD	Headache	✓	✓	✓
SD	Oedema peripheral	✓	✓	✓
SD	Ovarian cyst	✓	·	✓
SD	Pregnancy	·	·	✓
SD	Premature ovulation	·	·	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓

✓ active code · ○ coded but marked inactive · blank = not in that release